Older adults frequently experience anxiety symptoms as physical problems such as headaches, gastrointestinal distress, fatigue, and the like. As noted above, anxiety disorders often co-occur with other disorders that produce symptoms similar to anxiety. These issues pose significant detection and diagnostic challenges. The major distinctions between anxiety disorders and normal worries are perceived distress and ability to function. Although serious anxiety disorders usually interfere with functioning in some way, mild or moderate anxiety may not be apparent unless medical professionals probe a bit for information.
Ask your patients whether there are aspects of life that are causing concern. It does not mean living alone; it means being largely cut off from the outside world. Many people who live alone have friends, go out, and have active interests. Some people are isolated because of physical problems, but many people are isolated because they are too depressed to rouse themselves or too frightened to leave their homes. Frequently they are caught in a vicious cycle.
Breaking the cycle of isolation is exceedingly difficult and often requires persistent outreach and great patience. Perhaps the easiest to integrate and use in a primary healthcare setting is the GAD-7 scale,13 which is a self-administered and brief assessment measure. Of course, self-administered screenings are of limited value if the person taking it has significant memory loss or cognitive impairment.
Sometimes caregivers can provide the needed information, but they do not always know the inner thoughts and feelings of the person for whom they are caring. A screening tool does not produce a diagnosis. It gives a good indication that a diagnosis may be warranted, but the diagnosis itself must be made by a professional with appropriate expertise. Addressing Anxiety Disorders Healthcare professionals who provide services to older adults can intervene in ways that can be helpful to those with anxiety disorders.
Sometimes, however, it is critical for treatment to be provided by or in consultation with a geriatric mental health professional. Helpful interventions include various forms of support and guidance, psychotherapy, and—if used with caution—psychiatric medications. Supportive Interventions For some older adults with anxiety disorders, a relationship with a caring person who directly addresses isolation and inactivity can be very helpful. This can be a family member, a friend, a physician, a worker at a senior center, a clergyman or chaplain, or others.
Engaging people suffering from anxiety in social, creative, or other activities they find interesting can be very helpful. Helping older adults manage matters that may be a source of anxiety, such as dealing with health issues, financial matters, and concerns about being a burden to others, can make a big difference. These disorders, which include ODD and CD, often first attract notice when they interfere with school performance or family and peer relationships, and frequently intensify over time.
Children with both conditions tend to have more difficult lives than those with ADHD alone because their defiant behavior leads to so many conflicts with adults and others with whom they interact. Early identification and treatment may, however, increase the chances that your child can learn to control these behaviors.
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Many children with ADHD display oppositional behaviors at times. He is likely to encounter frequent social conflicts and disciplinary situations at school.
adriwhitbpabcu.tk In many cases, particularly without early diagnosis and treatment, these symptoms worsen over time—sometimes becoming severe enough to eventually lead to a diagnosis of conduct disorder. Conduct disorder is a more extreme condition than ODD. Many children with CD were or could have been diagnosed with ODD at an earlier age—particularly those who were physically aggressive when they were younger. As the CD symptoms become evident, these children usually retain their ODD symptoms argumentativeness, resistance, etc as well.
This cluster of behaviors, combined with the impulsiveness and hyperactivity of ADHD, sometimes causes these children to be viewed as delinquents, and they are likely to be suspended from school and have more police contact than children with ADHD alone or ADHD with ODD. A child with ADHD and a coexisting disruptive behavior disorder is likely to be similar to children with ADHD alone in terms of intelligence, medical history, and neurological development.
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He is probably no more impulsive than children with ADHD alone, although if he has conduct disorder, his teachers or other adults may misinterpret his aggressive behavior as ADHD-type impulsiveness. A child with ADHD and CD does have a greater chance of experiencing learning disabilities such as reading disorders and verbal impairment.
Other indicators to look for include. Children with ADHD and disruptive behavior disorders often benefit from special behavioral techniques that can be implemented at home and at school. If your child has a diagnosis of coexisting ODD or CD, and well-planned classroom behavioral techniques in his mainstream classroom have been ineffective, this may lead to a decision to place him in a special classroom at school that is set up for more intensive behavior management.
Stimulants have been shown to help decrease verbal and physical aggression, negative peer interactions, stealing, and vandalism. For this reason, stimulants are usually the first choice in a medication treatment approach for children with ADHD and a coexisting disruptive behavior disorder. A child with a disruptive behavior disorder whose aggressive behavior continues untreated may start to identify with others who experience discipline problems.
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